Remote Provider Enrollment/Credentialing Specialist

Practice Resources, LLC; City of Syracuse (NY); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in healthcare is seeking a Provider Enrollment/Credentialing Specialist to manage the enrollment process for new providers effectively. This remote role offers a competitive salary and a comprehensive benefits package, promoting a healthy work-life balance while ensuring compliance with enrollment processes for Medicare, Medicaid, and third-party providers.

Benefits

Health insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401K/Roth 401K options

PTO

Flex spending

Qualifications

• Minimum of 2 years’ experience in provider enrollment preferred.
• Professional written and verbal communication skills are essential.
• High School Diploma or GED required, Bachelor's preferred.

Responsibilities

• Initiate enrollment with insurance companies for all new providers.
• Maintain timelines on enrollment schedules and communicate with team members.
• Complete re-credentialing for existing providers.

Skills

Communication

Interpersonal skills

Knowledge of Medicare

Knowledge of Medicaid

Proficiency in Microsoft Word

Proficiency in Microsoft Excel

Education

High School Diploma or GED

Bachelor’s Degree

Tools

CAQH

PECOS

NPPES

Job description

Practice Resources, LLC (PRL) is seeking an experienced remote Provider Enrollment/Credentialing Specialist.

Qualifications:

• High School Diploma or GED required
• Bachelor’s Degree preferred
• Minimum of 2 years’ experience in provider enrollment preferred
• Knowledge of Medicare, Medicaid & third-party provider enrollment processes
• Proficiency in Microsoft Office, particularly Word and Excel
• Proficiency in CAQH, PECOS & NPPES preferred
• Professional written and verbal communication and interpersonal skills

Responsibilities and Duties:

• Initiate enrollment with insurance companies for all new providers
• Maintain timelines on enrollment schedules, communicate with billing and office managers on updates, and explain payer information requirements
• Work closely with physicians and office managers to obtain missing documentation for provider enrollment with insurance companies
• Follow-up with insurance companies on provider participation status
• Complete re-credentialing for existing providers
• Communicate effectively with team members, billing staff, and insurance companies
• Maintain detailed and accurate lists of insurances for which clients participate

Additional Information:

• Performs other related duties as needed, which may not be listed in the job description

Practice Resources, LLC offers a competitive salary and benefits package including health, dental, vision, disability, and life insurance, 401K/Roth 401K options, PTO, and flex spending. This is a remote position that allows you to manage a healthy work-life balance. The pay range for this position is: $17.00-$30.00 per hour.